Perforated colon symptoms

Updated November 21, 2016

A perforation or hole in the colon wall is an immediate medical emergency. The most common causes are trauma or infection; in some cases trauma can lead to an infection. The colon is an important part of maintaining the hydration status of the body. Any symptoms associated with a perforated colon should be taken very seriously. You should seek medical attention at once, as surgical repair is often needed to save the life of someone with this condition.

Purpose of the Colon

There are actually two colons, a large colon leading to a small colon. The job of the large colon is to absorb water and minerals from ingested matter. The small colon makes and folds waste for elimination. The walls of both are made of smooth muscle to move material along the tract. The lining is made up of selectively permeable cells that allow certain substance like water to pass but prevent bacteria from entering the body


With certain conditions like ulcerative colitis, the lining of the colon is eroded in places, allowing bacteria to infiltrate the tissue. In extreme cases, the bacteria can form a pocket that abscesses and perforates the wall. This results in an open channel for the microbes of the digestive tract to move into the abdominal cavity.


Occasionally a normal, healthy colon is injured, resulting in a perforation or tear. This can arise in many ways from an impaling injury where a foreign object moves through the body creating a hole. It also can occur when the abdomen is crushed devitalising the tissue creating many small perforations or leaks into the abdomen.


A perforation of the intestine is life-threatening, and your body knows this. Symptoms are severe abdominal pain, fever, nausea and infection. There are usually significant symptoms prior to a perforation though. Abdominal pain, nausea, loss of appetite and diarrhoea are all signs you should seek medical attention.


If the intestinal wall is only weakened and not truly perforated, a lot of times medication and rest can repair the damage. If the intestinal wall is perforated immediate surgical repair is the only option. Following surgery, abdominal lavage, flushing of the abdominal cavity, may be needed. Powerful antibiotics prescribed by a physician should be taken as directed. Following all post-surgical instructions is vital, as the intestinal wall is still in a weakened state.

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